Abelism in Prescriptions

How the War on Drugs is Used Against People with Disabilities

Last fall, I was diagnosed with ADHD. I’ve likely had it my entire life, but women are far less likely to be diagnosed with attention-deficit disorders than men are. In fact, as much as 75% of the cases in girls and women are missed or blamed on depression or other factors.

Part of that is that ADHD in women and girls presents very differently than in men. Often women and girls with ADHD are over achievers with a lot of interests, but people call them lazy or messy or forgetful because of all the times they get distracted. But women with ADHD also often hyperfocus on things that they find interesting, making many people assume that since they can pay attention sometimes, when they aren’t doing it, it is by choice.

It’s really not.

There are times when I am having a conversation with friends and my mind jumps a million miles away to some tangent based on what they said. And it makes me seem like I’m not paying attention, even though I was trying really hard to pay attention.

Because of the way ADHD presents in women and girls, it is often dismissed as not a real disability or not as bad as it is for men and boys. Or it is just misdiagnosed altogether.

So when I got my diagnosis and got put on medication to help control it, I thought things would get better. And they did, sort of. But then I discovered an entirely new to me way that medicine and the law are used to punish disabled people for needing their meds.

The most common prescribed medicine for ADHD is Adderall, a form of amphetamine. And we all know that amphetamines are super bad, right?

Apparently, it’s bad enough that my doctor’s office regularly does urine tests to make sure I am on the medicine. Despite the fact that I need some of my other medications to live (my thyroid meds jump to mind), no one has ever insisted on testing me to make sure I am taking them.

But now that I have a disability requiring a specific controlled substance, I am suddenly no longer reliable and my doctor has to be sure I’m taking the meds. It’s insulting and an added expense that disabled people don’t need. sure, I’ll pee in a cup, but the ableism inherent in the requirement is mind-boggling.

And it gets worse.

Because it is a controlled substance, it can only be filled every 30 days. The law allows for a little wiggle room, but not much. But my doctor’s office, not so much.

For the record, my primary care doctor is off on maternity leave, so this is a fill-in that caused the problem. But it is also typical of how people with disabilities are treated.

My last dose of Adderall, from the prescription I have on hand, is Sunday morning. My doctor’s office knows this. And wrote the new prescription so that it cannot be filled until Monday.

So even thought I normally take this medication between 6 a.m. and 7 a.m. on Monday I will have to wait until after 9 when the pharmacy opens and can fill it. Like many medications, taking it off schedule usually makes for a lot of discomfort until you get back on schedule. For me, it will mean having all those ADHD symptoms while trying to work on a Monday morning.

And to be honest, I am privileged enough that I can run to the pharmacy and pick it up as soon as it is filled. Not everyone can.

The other thing that lawmakers have decided is a rule with some controlled substances, like Adderall, is that you cannot have it on auto refill. Every month with this disabling condition that makes it hard for me remember little things, I have to remember to go to or call my pharmacy on the specific day that I am allowed to refill my prescription.

It’s a logistical nightmare for many disabled folks.

I have reminders in my planner and in my phone, but you have to remember to look at those things. Or be able to handle it exactly when the reminder goes off. If you have another mental health issue that makes it difficult to do things like call the pharmacy? Tough luck.

The reality is lawmakers likely do not consider the impact on the disabled when making these arbitrary rules about how we acquire medication in this country. The abelism is so pervasive they don’t even think about how it might affect the people who actually need the medication.

And this is exactly why the war on drugs, especially once it turned to opioids and prescription medications is an abelist problem.

For example, my father-in-law, before he died, had several ruptured discs in his lower back due to poor exercise habits and a factory job lifting ridiculously heavy machine parts. If he had been younger, and in better overall health, the solution would have been back surgery.

But when he was young enough for that to be a good medical option, he couldn’t afford to miss the time at work required to have his back issues repaired. Once he was retired and had the time, his body would likely not have made it through the surgery. He had a bad heart, diabetes and high blood pressure.

So his doctors treated his back pain with opioids. For years. Then, suddenly, there was an opioid epidemic and his doctor had to fight to get him the same prescription he had been taking for years.

Was part of it an opioid addiction? Likely, but not in the manner people think. His body was addicted to the pain relief. Over the counter pain meds were not strong enough and come with their own health risks.

With a disabling back condition, and contributing health issues, he was treated like an addict for seeking out the same level of pain relief he had been receiving for years. This is ableism at work.

While we need to address the societal conditions and mental issues that lead to addiction, we also MUST address the ableism that is preventing people with chronic and disabling conditions from getting timely access to their medications. We cannot continue to expect disable people to have to jump through more hoops to get their necessary medications just because some other people have had a history of abusing those drugs.

We must find a way not to let abelism infuse every aspect of our society.